Organization
WILD WEST KIDS DENTAL BULLHEAD
Active
Other names
Kids Little Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD A DICARLO II DMD (OWNER)
(928) 718-7188
Entity
Organization
Contact information
Practice address
2401 MIRACLE MILE, BULLHEAD CITY, AZ 86442-7311
(928) 704-5573
Mailing address
2401 N STOCKTON HILL RD STE 1, KINGMAN, AZ 86401-4189
(928) 718-7188
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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